Ballot Question 1: Patient-to-Nurse Limits

Thursday

Oct 25, 2018 at 8:37 AM

Summary: The proposed law would limit how many patients could be assigned to each registered nurse in Massachusetts hospitals and certain other health care facilities. The maximum number of patients per registered nurse wold vary by type of unit and level of care, as follows:

--In units with maternity patients: (a) active labor patients: 1 patient per nurse; (b) during birth and for up to 2 hours immediately postpartum: 1 mother per nurse and 1 baby per nurse; (c) when the condition of the mother and baby are determined to be stable: 1 mother and her baby or babies per nurse; (d) postpartum: 6 patients per nurse; (e) intermediate care or continuing care babies: 2 babies per nurse; (f) well-babies: 6 babies per nurse.

--In units with pediatric, medical, surgical, telemetry, or observational/outpatient treatment patients, or any other unit: 4 patients per nurse; and

The proposed law would require a covered facility to comply with the patient assignment limits without reducing its level of nursing, service, maintenance, clerical, professional or other staff.

The proposed law would also require every covered facility to develop a written patient acuity tool for each unit to evaluate the condition of each patient. This tool would be used by nurses in deciding whether patient limits should be lower than the limits of the proposed law at any given time.

The proposed law would not override any contract in effect on Jan. 2, 2019, that set high patient limits. The proposed law's limits would take effect after any such contract expired.

The state Health Policy Commission would be required to promulgate regulations to implement the proposed law. The Commission could conduct inspections to ensure compliance. Any facility receiving written notice from the Commission of a complaint or violation would be required to submit a written compliance plan to the Commission. The Commission could report violations to the state Attorney General, who could file suit to obtain a civil penalty of up to $25,000 per violation as well as up to $25000 for each day a violation continued after the Commission notified the facility of the violation. The Health Police Commission would be required to establish a toll-free telephone number for complaints and a website where complaints, compliance plans, and violations would appear.

The proposed law wold prohibit discipline or retaliation against any employee for complying with the patient assignment limits of the law. The proposed law would required every covered facility to post within each unit patient room, and waiting area a notice explaining the patient limits and how to report violations. Each day of a facility's non-compliance with the posting requirement would be punishable by a civil penalty between $250 and $2,500.

The proposed law's requirements would be suspended during a state or nationally declared emergency.

The proposed law states that, if any of its parts were declared invalid, the other parts would stay in effect. The proposed law would take effect on Jan. 1, 2019.

A YES vote would limit the number of patients that could be assigned to one registered nurse in hospitals and certain other health care facilities.

A NO vote would make no change in current laws relative to patient-to-nurse limits.

Source: William Francis Galvin, Secretary of the Commonwealth, "Massachusetts Information for Voters 2018 Ballot Questions," available online at http://www.sec.state.ma.us/ele/ele18/ballot_questions_18/ballot_questions18.htm and in the print edition sent to voters by mail.